Healthy Eating

The connection between diet and health conditions, such as RA, is something that both doctors and patients have been interested in for centuries. Recently, there has been a surge in interest among doctors about the potential benefits of dietary interventions in managing RA. As patients, we may notice which dietary choices seem to exacerbate our symptoms and which ones help us feel better.
Recent studies have examined a number of dietary interventions for RA. These include specific diets, such as the Mediterranean diet, which emphasizes plant foods (vegetables, fruits, cereals, beans, nuts and seeds), olive oil, and fish. Studies have also looked at the benefits of vegetarian diets, vegan diets, and diets designed to eliminate potential allergens that seem to trigger symptoms in some RA patients.

Specific Diets and RA Symptoms

Currently, there is not enough high-quality research to provide recommendations for using special diets to control RA symptoms. As more research is done in this area, recommendations may eventually change. For now, the following is some of the preliminary research being done in the field:

Mediterranean Diet
A Mediterranean diet emphasizes consumption of plant-based foods, including vegetables, fruits, whole grains, pasta, cereals, legumes, nuts, and seeds. These food sources are typically eaten fresh, with limited preparation. Olive oil is the main source of fat in the diet. Fish is eaten frequently, and red meat is only eaten a few times per month. Additionally, a small amount of red wine is included on most days.

Several studies have shown symptom improvements in RA patients following a Mediterranean diet. In one study, patients reported reduced inflammation, increased ability to perform physical activities, and increased feelings of vitality when compared to RA patients who continued their regular diet.

Vegetarian or Vegan Diets
Other studies have investigated the effects of vegetarian and vegan diets on RA symptoms. A gluten free vegan diet helped decrease LDL cholesterol levels and reduce inflammation in RA patients. A 7-10 day fast followed by a year-long vegetarian diet helped reduce inflammation, pain, stiffness, and swelling of joints and improved grip-strength in RA patients, when compared to those who followed their usual diet. These improvements were evident one month into the diet, and lasted for the entire 1-year duration of the study. A third study tested the effects of a very low fat (<10% calories from fat) vegan diet, and found that after 1 month patients lost weight, had reduced RA symptoms, and lower levels of inflammation than they did before they changed their diet. Gluten Free or Allergen Free Diets
A subset of RA patients may have undiagnosed food allergies or sensitivities that contribute to their RA symptoms. For these individuals, diets that remove typical food allergens such as wheat, barley, rye, oats (that are not gluten-free) and milk may help reduce symptom severity.
One single-blind, placebo-controlled elimination study conducted in 53 patients with RA found that a diet which eliminated foods that triggered RA symptoms resulted in significant decreases in pain and improvements in morning stiffness, joint involvement, grip strength, and walking speed. A majority of patients who completed the study reported that they felt “better” or “much better” when they adhered to the diet that avoided certain foods.

It is important to note that allergen-free diets did not help all RA patients, only a small portion that already had food allergies.

Big Picture:
The Mediterranean diet, vegan, and vegetarian diets typically boost fruit and vegetable consumption. The increase in antioxidants and boost in healthy-fat consumption may account for why the diets help reduce systemic inflammation.

To date, there are no special diets officially recommended for the treatment of RA. The Academy of Nutrition and Dietetics reviewed the literature in 2010 and concluded that “the effects of dietary manipulation, including vegetarian, Mediterranean, and elemental eating plans, and elimination diets on rheumatoid arthritis are still uncertain due to the included studies being small, single trials with moderate to high risk of bias.”

Effects of Specific Foods on RA Symptoms

In addition to general dietary patterns, researchers have also investigated how specific foods and nutrients affect RA symptoms. Click the navigation links to the left to learn more about how certain foods are related to RA or click on the select navigation to the left to view all nutrition articles.

Written by: Jonathan Simmons | Last reviewed: September 2013.
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